Request Medical Records

• Request medical records online (For patients only: Click here)

Please note by clicking on the above link, you will navigated to our business associate’s website to complete your request.

• Request medical records online (click here)

If you would like to request pathology materials, please contact the Pathology Department directly at:

210 Westchester Avenue, White Plains, NY 10604 (3rd floor behind Eye Care)
Phone: 914-831-6813
Fax: 914-682-6405
Hours of operation are Monday through Friday from 8:00 a.m. to 5:00 p.m.

Please note by clicking on the above link, you will navigated to our business associate’s website to complete your request.

• To request a copy of your medical records online, click here.

Please note by clicking on the above link, you will navigated to our business associate’s website to complete your request.

Access your patient portal: MyChart Login

For more information, contact us Monday through Friday, 8am to 8pm (EST) at 1-866-450-1901.

• Request medical records online: SmartRequest (3rd party requestors only)

If you would like to request the release of anatomic pathology materials, you can:

• Print the Authorization for Release of Pathology Slides, Blocks, and/or Reports and mail or fax it to the Pathology Department:

Summit Health
Pathology Department​
1225 McBride Avenue, Suite 120
Woodland Park, NJ 07424

Or

Fax: 973-435-7437

• Yourself (not a spouse)
• A parent if the patient is under the age of 18 years of age
• Court appointed guardian. (Must provide legal documents)
• Power of Attorney if patient is unable to sign (must have documentation)
• Executor/representative of estate for deceased patient with a copy of the short form (death certificate presented)
• A minor may sign their own authorization if they are:
  • Emancipated
  • Pregnant
  • Being treated for venereal disease, sexual assault, alcohol or drug use/abuse
  • Age 14 or older and is admitted to a psychiatric facility, children’s crisis intervention service or special psychiatric hospital operated by a state-licensed mental health provider

Both HIPAA and state rules determine the applicable fee for medical records. If there is a fee to process your request, the invoice will be mailed to the address listed on the release form. Payments can be made by credit card or check. Please make checks payable to: Ciox Health.

Yes, you can have a consolidated summary of your health record sent to you instantly via email when you visit the “My Health > Health Records” section of the new Summit Health portal. To access this copy of your medical records, login to your portal from a web browser from a desktop, and click “My Health”. You’ll navigate to “Health Records” and select Outpatient Visit Documentation you are hoping to export – information such as medications list, allergies and immunizations will be included in this data. You can specify a date range, or access this information from your “all time” record.

All requests are worked in the order received. Processing may take up to 10 days from the date a valid authorization is received, however this is not typical.

1. Print the PATIENT REQUEST FOR AMENDMENT OF PATIENT HEALTH INFORMATION form.
2. Complete the form, providing the date(s) of service, the information you are requesting to amend or correct, and the reason for making the request.
3. Your signature must appear on the form to be considered valid. Electronic signatures or Adobe-generated signatures are not accepted.
4. Once the form has been completed and signed, you may either email the form to patientamendments@summithealth.com or you may mail it to the Health Information Management (HIM) Department ATTN: Patient Amendments at 1 Diamond Hill Rd, Berkeley Heights, NJ 07922.

Please Note: Summit Health may take up to 60 days from the date the request was received to provide you with a response.